Diagnosing Stroke from Miles Away

June 01, 2013

In a situation where time is of the essence, the Telestroke network connects stroke specialists with far-off patients.

Providence Health & Services, Southern California, has developed the first-of-its-kind “hub and spoke” network in the greater Los Angeles area to help stroke patients get the fast treatment they need. This new Providence Telestroke Network, made possible by a secure, two-way video-conferencing system, allows neurologists to be “in the room” with patients who may be at hospitals miles away.

Read on to discover more about the groundbreaking network that’s expanding expert stroke care into greater L.A. – and the technology that makes it happen.

Taking Care to the Community

When it comes to stroke, time is brain. “The faster patients can be diagnosed and treated for stroke, the better their outcomes. This can be a challenge in small, urban community hospitals, where 24-hour access to stroke specialists is unpredictable or not available,” says Patrice Hallak, PT, MBA, regional director of neurosciences and orthopedics for Providence Health & Services, Southern California.

That’s why Providence Saint Joseph Medical Center has launched a network that connects neurologists with patients via a live video-conference feed. They Hycy and Howard Hill Neuroscience Institute at Providence Saint Joseph serves as the hub for the network, which launched in May with five partner sites, or “spokes”. Hallak says Providence Saint Joseph hopes to expand its network to 10 partner sites by year’s end, and Providence Tarzana Medical Center has also launched a Telestroke program.

Every Second Counts

When it comes to stroke, why is quick treatment so crucial? Most strokes occur when a clot blocks blood flow to the brain. This type of stroke must be treated within a three-hour window with a clot busting drug called tissue plasminogen activator, or tPA.

But what if you’re at a small, community hospital that lacks the resources to see whether tPA is warranted? Or what if the on-call neurologist lives 40 minutes away?

That’s where Telestroke comes in.

“Telestroke is a secure, computer-based system neurologists use to actually see a patient live and remotely,” says Craig German, MD, a neurologist at Providence Holy Cross Medical Center, which was the first Providence hospital in Southern California to use Telestroke.

Similar to Skype and other online video chat services, Telestroke offers remote communication – but with exceptional image and sound quality, plus the additional ability for neurologists to securely download and review brain imaging.

“Neurologists are not always physically at the hospital. This way, if I am not there, I can still talk to the patient and see the patient – in fact, I can zoom in as close as the pupil,” says Dr. German, adding that the Telestroke camera is remotely controlled by the off-site neurologist, who can “move around” to see the patient or look at the vital signs monitor or patient chart. Likewise, the patient can see the neurologist on a computer monitor via a live video feed.

It’s the next best thing to having a neurologist in the room.

This allows the tPA, if warranted, to commence quickly. “Stroke treatment has a definite time window of three hours. Time really is of the essence,” Dr. German says.

In conjunction with the launch of its Telestroke network, Providence Saint Joseph has taken the technology to the next level by deploying the next generation of Telestroke – a telemedicine robot that can be programmed to negotiate its environment independently. The exam room’s parameters can be preprogrammed into the robot so that it knows where “to go” at all times—no human control needed.

The latest technology. And a network that shares it with our communities—fast. Providence is proud to deliver stroke technology and treatment at its finest.